DSpace Collection: Impacto MundialImpacto Mundialhttp://www.dspace.uce.edu.ec/handle/25000/35922018-12-12T10:05:27Z2018-12-12T10:05:27ZLocals get travelers' diarrhea too: risk factors for diarrheal illness and pathogenic E. coli infection across an urban-rural gradient in EcuadorSánchez, XavierSmith, Shanon M.Montero, LorenaPaez, MaritzaOrtega, EstefaniaHall, EricBohnert, KatePuebla, EdisonEndara, PabloCevallos, WilliamTrueba, GabrielLevy, Karenhttp://www.dspace.uce.edu.ec/handle/25000/168862018-11-20T21:23:10Z2018-01-01T00:00:00ZTitle: Locals get travelers' diarrhea too: risk factors for diarrheal illness and pathogenic E. coli infection across an urban-rural gradient in Ecuador
Authors: Sánchez, Xavier; Smith, Shanon M.; Montero, Lorena; Paez, Maritza; Ortega, Estefania; Hall, Eric; Bohnert, Kate; Puebla, Edison; Endara, Pablo; Cevallos, William; Trueba, Gabriel; Levy, Karen
Abstract: Objectives: Diarrhea is a common and well-studied cause of illness afflicting international travelers. However, traveler’s diarrhea can also result from travel between high and low disease transmission regions within a country, which is the focus of this study.
Methods: We recruited participants for a case-control study of diarrhea at four sites along an urbanrural gradient in Northern Ecuador: Quito, Esmeraldas, Borbón and rural communities outside of
Borbón. At each of these sites, approximately 100 subjects with diarrhea (cases) were recruited from Ministry of Health clinics and were age-matched with subjects visiting the same clinics for other complaints (controls).
Results: Travelers to urban destinations had higher risk of diarrhea and diarrheagenic E. coli (DEC) infections. Travel to Quito was associated with diarrhea (aOR = 2.01, 95% CI = 1.10-3.68) and travel to Guayaquil (another urban center in Ecuador) was associated with Diffuse Adherent E. coli infection (OR = 2.09, 95% CI = 1.01-4.33). Compared to those not traveling, urban origins were also associated with greater risk of diarrhea in Esmeraldas (aOR = 2.28, 95% CI = 1.20-4.41), and with higher risk of diarrheagenic E. coli infections in Quito (aOR = 2.61, 95% CI = 1.16-5.86), with >50% of travel from Quito and Esmeraldas specified as to another urban destination.
Conclusions: This study suggests that individuals traveling from lower transmission regions (rural areas) to higher transmission regions (urban centers) within a single country are at a greater risk of acquiring a diarrhea-related illness. Investments to improve water, sanitation and hygiene conditions in urban areas could have impacts on outlying rural areas within a given country.2018-01-01T00:00:00ZMigración y trabajo digno en la agricultura familiar del norte del Ecuador a lo largo del año 2016Eche Enríquez, Davidhttp://www.dspace.uce.edu.ec/handle/25000/168852018-11-20T21:04:58Z2017-01-01T00:00:00ZTitle: Migración y trabajo digno en la agricultura familiar del norte del Ecuador a lo largo del año 2016
Authors: Eche Enríquez, David
Abstract: Obedeciendo los parámetros postulados en la agenda de trabajo decente de la Organización Internacional del Trabajo (OIT), este estudio de
investigación explora las condiciones laborales de la agricultura como los principales factores determinantes de la migración rural en tres
regiones del norte del Ecuador. Con tal propósito, asume los enfoques de la agricultura familiar y de la juventud rural. Mediante métodos
cualitativos y cuantitativos, se demuestra que la ausencia de trabajo decente incrementa la propensión de los agricultores a migrar y a la
participación en nuevas actividades económicas, como la elaboración de artesanías y la venta de la mano de obra fuera de la finca. En tanto, la
juventud rural considera que la precariedad laboral, los bajos ingresos económicos y la explotación laboral en la agricultura, así como la falta
de empleo rural adecuado y digno, constituyen las principales causas de la migración y el abandono de la agricultura.; Following the parameters postulated in the decent work agenda of the International Labor Organization (ILO), this research study explores
the working conditions of agriculture as the main determinants of rural migration in three regions of northern Ecuador. For this purpose, we
assume the approaches of family farming and rural youth. We demonstrate through qualitative and quantitative methods that the absence of
decent work increases the propensity of farmers to migrate and participate in new economic activities, such as the making of handicrafts and
the sale of labor outside the farm. Meanwhile, rural youth consider that precarious working conditions, low economic income, and labor exploitation in agriculture, as well as the lack of adequate and dignified rural employment, are the main causes for migration and
the abandonment of agriculture.2017-01-01T00:00:00ZArtery of percheron infarct: an acute diagnostic challenge with a spectrum of clinical presentationsEspinosa del Pozo, Patricio H..Khanni, Javed L.Casale, Joel A.Koek, Adriana Y.Espinosa, Patricio S.http://www.dspace.uce.edu.ec/handle/25000/168642018-11-19T20:52:17Z2018-01-01T00:00:00ZTitle: Artery of percheron infarct: an acute diagnostic challenge with a spectrum of clinical presentations
Authors: Espinosa del Pozo, Patricio H..; Khanni, Javed L.; Casale, Joel A.; Koek, Adriana Y.; Espinosa, Patricio S.
Abstract: The artery of Percheron (AOP) is a variant of the paramedian thalamic vasculature that supplies blood to the medial aspect of the thalamus and the rostral midbrain. The presentation of an infarct in this territory varies widely and is often characterized by nonspecific neurological deficits, with altered mental status, decreased level of consciousness, and memory impairment being among the most common. AOP infarcts are often missed on initial computed tomography (CT) scan, and additional imaging is usually not done due to low suspicion for stroke in most cases. There have been an increasing number of reports of AOP infarction, illustrating the diversity of clinical presentations and the challenge this presents to clinicians in the acute setting. Lacking the classic signs of stroke, many of these patients experience a delay in recognition and treatment, with the majority of diagnoses occurring outside the tissue plasminogen activator (tPA) window. This case highlights the unusual presentation and diagnostic difficulty of a patient with an AOP infarct, and serves as a reminder to include thalamic pathology in patients presenting with vague neurological symptoms and no obvious signs of stroke.2018-01-01T00:00:00ZUse of Real-Time Polymerase Chain Reaction to Differentiate between Pathogenic Entamoeba histolytica and the Nonpathogenic Entamoeba dispar in EcuadorGuevara, AngelVicuña, YosselinCostales, DenisseVivero, SandraAnselmi, MariellaBisoffi, ZenoFormenti, Fabiohttp://www.dspace.uce.edu.ec/handle/25000/168362018-11-13T20:28:20Z2018-01-01T00:00:00ZTitle: Use of Real-Time Polymerase Chain Reaction to Differentiate between Pathogenic Entamoeba histolytica and the Nonpathogenic Entamoeba dispar in Ecuador
Authors: Guevara, Angel; Vicuña, Yosselin; Costales, Denisse; Vivero, Sandra; Anselmi, Mariella; Bisoffi, Zeno; Formenti, Fabio
Abstract: Microscopic examination of stool samples has been considered to be the “gold standard” for diagnosis of
intestinal parasites. Recently, polymerase chain reaction (PCR) has been approved by the World Health Organization as
the method of choice for the diagnosis of Entamoeba histolytica. Of the 106 stool samples collected from the Esmeraldas
and Pichincha provinces of Ecuador, all (100%) were positive for E. histolytica/Entamoeba dispar by light microscopy,
whereas using real-time PCR (RT-PCR) DNA amplification, 74 (69.8%) were positive for E. dispar and only three (2.8%)
were positive for E. histolytica. Some 29 (27.4%) samples were negative for the presence of either E. histolytica or
E. dispar, this may be due the presence of Entamoeba mosksvskii, which is morphologically identical to E. histolytica/
E. dispar and not specifically targeted by the RT-PCR used. These results indicate the necessity of reevaluating the
epidemiology of amebiasis in Ecuador as the prominent species found are nonpathogenic.2018-01-01T00:00:00Z